Minnesota Administrative Rule ADC 9544.0090 – Applies to residential, child care, healthcare, mental health, social services, senior, developmental disabilities et al.
Core training for staff.
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- The license holder must ensure that staff responsible to develop, implement, monitor, supervise, or evaluate positive support strategies, a positive support transition plan, or the emergency use of manual restraint complete a minimum of eight hours of training from qualified individuals prior to assuming these responsibilities. Core training includes requiring staff to demonstrate knowledge of and competency in the following, in the setting in which services are provided:
- de-escalation techniques and their value;….
- principles of positive support strategies such as positive behavior supports, the relationship between staff interactions with the person and the person’s behavior, and the relationship between the person’s environment and the person’s behavior;
- what constitutes the use of restraint, including chemical restraint, time out, and seclusion;
- the safe and correct use of manual restraint on an emergency basis according to Minnesota Statutes, section 245D.061;
- staff responsibilities related to prohibited procedures under Minnesota Statutes, section 245D.06, subdivision 5; why the procedures are not effective for reducing or eliminating symptoms or interfering behavior; and why the procedures are not safe;
- Staff responsibilities related to restricted and permitted actions and procedures under Minnesota Statutes, section 245D.06, subdivisions 6 and 7;
H. the situations in which staff must contact 911 services in response to an imminent risk of harm to the person or others;…. - Annual refresher training.
- The license holder must ensure that staff responsible to develop, implement, monitor, supervise, or evaluate positive support strategies, a positive support transition plan, or the emergency use of manual restraint complete a minimum of eight hours of training from qualified individuals prior to assuming these responsibilities. Core training includes requiring staff to demonstrate knowledge of and competency in the following, in the setting in which services are provided:
245D.061 Emergency Use of Manual Restraints.
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- Conditions for emergency use of manual restraint. Emergency use of manual restraint must meet the following conditions:
- immediate intervention must be needed to protect the person or others from imminent risk of physical harm; and
- the type of manual restraint used must be the least restrictive intervention to eliminate the immediate risk of harm and effectively achieve safety. The manual restraint must end when the threat of harm ends.
- Monitoring emergency use of manual restraint. The license holder shall monitor a person’s health and welfare during an emergency use of a manual restraint. Staff monitoring the procedure must not be the staff implementing the procedure when possible. The license holder shall complete a monitoring form, approved by the commissioner, for each incident involving the emergency use of a manual restraint.
- Conditions for emergency use of manual restraint. Emergency use of manual restraint must meet the following conditions:
245D.06 Protection Standards
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- Prohibited procedures. The license holder is prohibited from using chemical restraints, mechanical restraints, manual restraints, time out, seclusion, or any other aversive or deprivation procedure, as a substitute for adequate staffing, for a behavioral or therapeutic program to reduce or eliminate behavior, as punishment, or for staff convenience.
- .Restricted procedures. (a) The following procedures are allowed when the procedures are implemented in compliance with the standards governing their use as identified in clauses (1) to (3). Allowed but restricted procedures include:
- permitted actions and procedures subject to the requirements in subdivision 7;
- procedures identified in a positive support transition plan subject to the requirements in subdivision 8; or
- emergency use of manual restraint subject to the requirements in section 245D.061.
- A restricted procedure identified in paragraph must not:
- be implemented with a child in a manner that constitutes sexual abuse, neglect, physical abuse, or mental injury…
- be used for the convenience of staff, as punishment, as a substitute for adequate staffing, or as a consequence if the person refuses to participate in the treatment or services provided by the program;
- use prone restraint. For purposes of this section, “prone restraint” means use of manual restraint that places a person in a face-down position. Prone restraint does not include brief physical holding of a person who, during an emergency use of manual restraint, rolls into a prone position, if the person is restored to a standing, sitting, or side-lying position as quickly as possible;
- apply back or chest pressure while a person is in a prone position, supine position, or side-lying position; or
- be implemented in a manner that is contraindicated for any of the person’s known medical or psychological limitations.
- .Permitted actions and procedures.
- Physical contact or instructional techniques must use the least restrictive alternative possible to meet the needs of the person and may be used:
- to calm or comfort a person by holding that person with no resistance from that person;
- to protect a person known to be at risk of injury due to frequent falls as a result of a medical condition;
- to facilitate the person’s completion of a task or response when the person does not resist or the person’s resistance is minimal in intensity and duration;
- to block or redirect a person’s limbs or body without holding the person or limiting the person’s movement to interrupt the person’s behavior that may result in injury to self or others with less than 60 seconds of physical contact by staff; or
- to redirect a person’s behavior when the behavior does not pose a serious threat to the person or others and the behavior is effectively redirected with less than 60 seconds of physical contact by staff.
- Physical contact or instructional techniques must use the least restrictive alternative possible to meet the needs of the person and may be used:
- Restraint may be used as an intervention procedure to:
- allow a licensed health care professional to safely conduct a medical examination or to provide medical treatment ordered by a licensed health care professional;
- assist in the safe evacuation or redirection of a person in the event of an emergency and the person is at imminent risk of harm; or
- position a person with physical disabilities in a manner specified in the person’s coordinated service and support plan addendum.
Use of adaptive aids or equipment, orthotic devices, or other medical equipment ordered by a licensed health professional to treat a diagnosed medical condition do not in and of themselves constitute the use of mechanical restraint.