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JKAA, Physical Restraint Policy and Procedures

 

 

PHYSICAL RESTRAINT POLICY AND PROCEDURES

 

Physical restraint shall mean direct physical contact that prevents or significantly restricts a student’s freedom of movement. Physical restraint does not include: brief physical contact to promote student safety, providing physical guidance or prompting when teaching a skill, redirecting attention, providing comfort, or a physical escort. 

Physical restraint shall be considered an emergency procedure of last resort and shall only be used when a student’s behavior poses a threat of assault, or imminent, serious, physical harm to self or others and the student is not responsive to verbal directives or other lawful and less intrusive behavior interventions, or such interventions are deemed to be inappropriate under the circumstances.

In the event that physical restraint is required to protect the safety of school community members, the Gardner School District has enacted the following policy and procedures to ensure the proper use of restraint and to prevent or minimize any harm to the student as a result of the use of restraint.

The use of time-out is a behavior support strategy in which a student temporarily separates from the learning activity or the classroom either by choice or direction from staff, for the purpose of calming. During a time-out the student must be continuously observed by a staff member.  Staff shall be with the student or immediately available to the student at all times. The space used for time-outs must be clean, safe, sanitary, and appropriate for the purposes of calming. Time-out shall cease as soon as the student has calmed. The Staff will seek the principal’s approval should a student require a time-out lasting more than 30 minutes due to continued agitation.

These procedures shall be annually reviewed, provided to school staff, and made available to parents of enrolled students.

NOTE:  None of the foregoing paragraph or the policy/procedures that follow, precludes any teacher, employee or agent of the Gardner School District from using reasonable force to protect students, other persons or themselves from assault or imminent, serious, physical harm.

 

  1. Staff Training
    1. All staff/faculty will receive training regarding the school’s restraint policy within the first month of each school year, and employees hired after the school year begins will receive training within one month of starting their employment. Each principal or director shall determine a time and method to provide all program staff with training regarding the program’s restraint prevention and behavior support policy and requirements when restraint is used
    2. Required training for all staff will include review of the following:

(1)   The program's restraint prevention and behavior support policy and procedures, including use of time-out as a behavior support strategy distinct from seclusion;

(2)   Interventions which may preclude the need for restraint, including de-escalation of problematic behaviors; and other alternatives to restraint in emergency circumstances;

(3)   Types of restraints and related safety considerations, including information regarding the increased risk of injury to a student when an any restraint is used; in particular a restraint of extended duration;

(4)   Administering physical restraint in accordance with known medical or psychological limitations known or suspected trauma history,  and/or behavioral intervention plans applicable to an individual student; and

(5)   Identification of program staff who have received in-depth training (as set forth below in section C) in the use of physical restraint.

(6)   The role of the student, family, and staff in preventing restraint

  1. Designated staff members shall participate in at least sixteenhours of in-depth training in the use of physical restraint, with at least one refresher training occurring annually thereafter

(1)   At the beginning of the school year, the principal will identify those staff who will participate in in-depth training and who will then be authorized to serve as school-wide resources to assist in ensuring proper administration of physical restraint.

(2)   In-depth training will include:

  1. Appropriate procedures for preventing the need for physical restraint, including the de-escalation of problematic behavior, relationship building, and use of alternatives to restraint.
  2. A description and identification of specific dangerous behaviors on the part of a student that may indicate the need for physical restraint and methods for evaluating the risk of harm in individual situations in order to determine whether the use of restraint is warranted;
  3. The simulated experience of administering and receiving physical restraint, instruction regarding the effect(s) on the person restrained, including instruction on monitoring physical signs of distress and obtaining medical assistance;
  4. Instruction regarding documentation and reporting requirements and investigation of injuries and complaints; and
  5. Demonstration by participants of proficiency in administering physical restraint; and
  6. Instruction regarding the impact of physical restraint on the student and family, recognizing the act of restraint has impact, including but not limited to psychological, physiological, and social-emotional effects
  7. Staff/faculty will review any behavior plans pertaining to special techniques for identified students.
  8. Staff/ faculty will review the uses of time-out as a behavioral strategy for applicable programs. Staff/faculty will review the program procedure for obtaining principal approval of time-out for more than 30 minutes based upon a student’s continuing agitation.

 

  1. Administration of physical restraint
    1. Physical restraint shall be used only in emergency situations of last resort, after other lawful and less intrusive alternatives have failed or been deemed inappropriate, and with extreme caution. Staff will use physical restraint with two goals in mind:

(1)   To administer a physical restraint only when needed to protest a student and/or a member of the school community from assault or imminent, serious, physical harm; and

  1. To prevent or minimize any harm to the student as a result of the use of physical restraint. Physical restraint is prohibited in the following circumstances:

(1)   As a means of discipline or punishment;

(2)   As a response to property destruction, disruption of school order, a student’s refusal to comply with a school rule or staff directive, or verbal threats that do not constitute a threat of imminent, serious, physical harm. However, if the property destruction or the refusal to comply with a school rule or staff directive could escalate into, or could itself lead to serious, imminent harm to the student or to others, physical restraint is appropriate.

(3)   As a standard response for any individual student. No written behavior plan or individualized education program (IEP) may include use of physical restraint as a standard response to any behavior

(4)   When the student cannot be safely restrained because it is medically contraindicated for reasons including, but not limited to, asthma, seizures, a cardiac condition, obesity, bronchitis, communication-related disabilities, or risk of vomiting

  1. Only school personnel who have received required training or in-depth training pursuant to this policy shall administer physical restraint on students with, whenever possible, one adult witness who does not participate in the restraint. The training requirements, however, shall not preclude a teacher, employee or agent of the school from using reasonable force to protect students, other persons or themselves from assault or imminent, serious, physical harm.
  2. Physical restraint shall be limited to the amount of force necessary to protect a student or others from, physical injury or harm.
  3. A person administering physical restraint shall use the safest method available and appropriate to the situation.  Restraints, including prone restraints otherwise permitted under 603 CMR 46.03(1)(b) may only be administered by a staff member who has received in-depth training as specified in this policy and, when in the judgment of the trained staff member, such method is required to provide safety for the student or others.
  4. Physical restraint shall be discontinued as soon as the student is no longer an immediate danger to himself or others, or the student indicates that he or she cannot breathe, or if the student is observed to be in severe distress, such as having difficulty breathing, or sustained or prolonged crying or coughing.
  5. Additional safety requirements:

(1)   No restraint shall be administered in such a way that the student is prevented from breathing or speaking. A staff member will continuously monitor the physical status of the student, including skin temperature color and respiration, during the restraint.

(2)   If at any time during a physical restraint the student expresses or demonstrates significant physical distress, including but not limited to, difficulty breathing, the student shall be released from the restraint immediately, and school staff shall take steps to seek medical assistance.

(3)   Program staff shall review and consider any known medical or psychological limitations, known or suspected trauma history, and/or behavioral intervention plans regarding the use of physical restraint on an individual student.

(4)   If a student is restrained for a period longer than 20 minutes, staff shall obtain the approval of administration. The approval shall be based upon the student’s continued agitation during the restraint justifying the need for continued restraint.

  1. At an appropriate time after release of a student from physical restraint, a school administrator or other appropriate school staff shall:

(1)   Review the incident with the student to address the behavior that precipitated the restraint;

(2)   Review the incident with the staff person(s) who administered the restraint to discuss whether proper restraint procedures where followed; and

(3)   Consider whether any follow-up is appropriate for students who witnessed the incident.

  1. Restraints prohibited
    1. Medication restraint – the administration of medication for the purpose of temporarily controlling behavior.– is prohibited unless prescribed by a licensed physician and authorized in writing by the parent for administration in the school setting
    2. Mechanical restraint – the use of any  device or equipment to restrict a student’s freedom of This does not include devices implemented by trained school personnel, or utilized by a student that have been prescribed by an appropriate medical or related services professional, and are used for the specific and approved positioning or protective purposes for which such devices were designed. Examples of such devices include: adaptive devices or mechanical supports used to achieve proper body position, balance, or alignment to allow greater freedom of mobility than would be possible without the use of the device or mechanical supports; vehicle safety restraints when used as intended during the transport of a student in a moving vehicle; restraints for medical immobilization; or orthopedically prescribed devices that permit a student to participate in activities without risk of harm.
    3. Seclusion restraint - the involuntary confining a student alone in a room or area from which the student is physically prevented from leaving without access to school staff  is prohibited.
    4. Prone restraint- a physical restraint in which a student is placed face down on the floor or another surface, and physical pressure is applied to the student’s body to keep the student in the face down position is prohibited except under the following circumstances:

(1) The student has a documented history of repeatedly causing serious self-injuries     and/or injuries to other students or staff;                 

(2) All other forms of physical restraints have failed to ensure the safety of the student            and/or the safety of others;

(3) There are no medical contraindications as documented by a licensed physician;

(4) There is psychological or behavioral justification for the use of prone restraint and there are no psychological or behavioral contraindications, as documented by a        licensed mental health professional;

(5) The program has obtained consent to use prone restraint in an emergency as set       out in 603 CMR 46.03(1)(b), and such use has been approved in writing by the   principal; and,

(6) The program has documented 603 CMR 46.03(1)(b) 1 - 5 in advance of the use of             prone restraint and maintains the documentation.

  1. The use of “time out” procedures during which a staff member remains accessible to the student, and the student is continuously observed by a staff member shall not be considered “seclusion restraint.
  2. Reporting requirements
    1. Staff will report any incidence of physical restraint to their building administrator.  Program staff shall provide a written report no later than the next school working day to their building administrator after administration of a physical restraint
    2. The staff member who administered such a restraint shall verbally inform the principal of the restraint as soon as possible and by written report no later than the next school working day.

(1)   The written report shall be provided to the principal or his/her designee, except the principal shall prepare the report if the principal administered the restraint;

(2)   The principal or his/her designee shall maintain an on-going record of all reported instances of physical restraint, which shall be made available for review by the parent or the Department of Education, upon request.

  1. The principal or his/her designee shall verbally inform the student’s parent(s)/guardian(s) of such restraint as soon as possible and within 24 hours of the restraint, and by written report postmarked no later than three school working days following the use of such restraint or to an email address provided by the parent for communication about the student

(1)   If the school customarily provides school-related information to the parent(s)/guardian(s) in a language other than English, the written restraint report shall be provided in that language.

(2)   The school will provide the student and the parent an opportunity to comment orally and in writing on the use of the restraint and on information in the written report.

  1. The written report required by both sections B and C above shall include:

(1)               Names and job title of the staff who administered the restraint, and observers, if any;

(2)               Date of restraint and time restraint began and ended;

(3)               Name of administrator who was verbally informed following the restraint; and as applicable, the name of the administrator who approved continuation of the restraint beyond 20 minutes.

(4)               Description of the activity the student, other students, and staff in the area were engaged in immediately preceding the use of physical restraint;

(5)               Student’s behavior that prompted the restraint;

(6)               Efforts made to de-escalate the situation and alternatives to restraint that were attempted;

(7)               Justification for initiating physical restraint;

(8)               Description of administration of restraint including:

  1. The holds used and reasons such holds were necessary
  2. The student’s behavior and reactions during the restraint
  3. How the restraint ended and
  4. Documentation of injury to the student and/or staff, if any, during the restraint and any medical care provided;

(9)               For extended restraints (restraints lasting more than twenty minutes), description of the alternatives to extended restraint that were attempted, the outcome of those efforts, and the justification for administering the extended restraint; Information regarding any further action(s) that the school has taken or may take, including any disciplinary sanctions that may be imposed on the student; and

(10)           Information regarding opportunities for the student’s parent(s)/guardian(s) to discuss with school officials the administration of the restraint, any disciplinary sanctions, and/or other related matters.

  1.  Individual student review.  The principal shall conduct a weekly review of restraint data to identify students who have been restrained multiple times during the week.  If such students are identified, the principal shall convene one or more review teams as the principal deems appropriate to assess each student’s progress and needs. The assessment shall include at least the following:

(1) Review and discussion of the written reports submitted in accordance with                 603 CMR 46.06 and any comments provided by the student and parent about              such reports and the use of the restraints;

(2) Analysis of the circumstances leading up to each restraint, including factors               such as time of day, day of the week, antecedent events, and individuals                      involved;

(3) Consideration of factors that may have contributed to escalation of behaviors,             consideration of alternatives to restraint, including de-escalation techniques                and possible interventions, and such other strategies and decisions as                           appropriate, with the goal of reducing or eliminating the use of restraint in the             future; 

(4) Agreement on a written plan of action by the program

If the principal directly participated in the restraint, a duly qualified individual designated by the superintendent shall lead the review team’s discussion.  The principal shall ensure that a record of each individual student review is maintained and made available for review by the Department or the parent, upon request.

  1. Administrative review.  The principal shall conduct a monthly review of school-wide restraint data.  This review shall consider patterns of use of restraints by similarities in the time of day, day of the week, or individuals involved; the number and duration of physical restraints school-wide and for individual students; the duration of restraints; and the number and type of injuries, if any, resulting from the use of restraint.  The principal shall determine whether it is necessary or appropriate to modify the school’s restraint prevention and management policy, conduct additional staff training on restraint reduction/prevention strategies, such as training on positive behavioral interventions and supports, or take such other action as necessary or appropriate to reduce or eliminate restraints. 
  2. Report all restraint related injuries to the Department of Secondary and Elementary Education (DESE). When a physical restraint has resulted in an injury to a student or program staff member, the program shall send a copy of the written report required to the Department postmarked no later than three school working days of the administration of the restraint. The program shall also send the Department a copy of the record of physical restraints maintained by the principal for the 30-day period prior to the date of the reported restraint. The Department shall determine if additional action by the program is warranted and, if so, shall notify the program of any required actions within the 30 calendar days of receipt of the required written report(s).
  3. The district will report all physical restraints to the Department. Each school shall collect and annually report data regarding the use of physical restraints in a manner and form directed by the Department.
  4. Grievance procedures
    1. Parents will notify the principal or designee of any concerns regarding restraint practices and procedures. If a designee receives the complaint or concern that designee shall notify the principal within the school day. The principal shall notify the Superintendent within twenty-four hours of a school working day of receiving a concern. The Superintendent shall at his or her discretion order an investigation.
  5. Other interventions. Nothing in this policy prohibits:
    1. The right of any individual to report to appropriate authorities a crime committed by a student or another individual;
    2. Law enforcement, judicial authorities or school security personnel from exercising their responsibilities, including physical detainment of a student or other person alleged to have committed a crime or posing a security risk; or
    3. The exercise of an individual’s responsibilities as a mandated reporter or to deter any individual from reporting neglect or abuse to the appropriate state agency.
    4. Policies and Procedures shall not preclude the use of school violence prevention techniques or procedures i.e., counseling, DARE, etc.

 

 [Adopted: December 2001]

 

[Revised: October 2003]

 

[Revised: March 2006]

 

[Revised: April 2008]

 

[Reviewed:  June 2014]

 

[Revised: March 2016]

 

LEGAL REFS.:

M.G.L. 69 Section 1B and C71, S37G,

Regulation 603 CMR 46.00 Physical Restraint

 

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