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Rule 159. (1) An institution must establish and follow written policies and procedures
regarding restraint. These policies and procedures shall be available to all residents, their
families, and referring agencies.
(2) Resident restraint must be performed in a manner that is safe, appropriate, and
proportionate to the severity of the minor child’s behavior, chronological and developmental age,
size, gender, physical condition, medical condition, psychiatric condition, and personal history,
including any history of trauma, and done in a manner consistent with the resident’s treatment
plan.
(3) Subrules (4) and (5) apply to those public or private licensed child caring institutions for
which the primary purpose is to serve juveniles that have been accused or adjudicated delinquent
for having committed an offense, other than a juvenile accused or adjudicated under section 2 of
chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2.
(4) Mechanical restraints must not be used on pregnant youth, including youth who are in
labor, delivery, and post-partum recovery, unless credible, reasonable grounds exist to believe
the youth presents an immediate and serious threat of hurting self, staff, or others.
(5) The following restraints are prohibited for use on pregnant youth unless reasonable grounds
exist to believe the youth presents an immediate and credible risk of escape that cannot be
reasonably minimized through any other method:
(a) Abdominal restraints.
(b) Leg and ankle restraints.
(c) Wrist restraints behind the back.
(d) Four-point restraints on known pregnant juveniles.
(6) The written policy must include all of the following:
(a) Procedures for the review of an incident of restraint within 48 hours by a level of
supervision above the staff ordering or conducting the restraint to determine if the requirements
of the institution’s procedures were adhered to in directing and conducting the restraint.
(b) Procedures for the provision of sufficient and adequate training for all staff members of the
institution who may use or order the use of restraint using the institution’s written procedures.
(c) Procedures for recording restraints as an incident report.
(d) Procedures for the review and aggregation of incident reports regarding restraints at least
biannually by the institution’s director or designee.
(7) The written policy must only permit the licensee to restrain a child for the following
circumstances:
(a) To prevent injury to the child, self-injury, or injury to others.
(b) As a precaution against escape or truancy.
(c) When there is serious destruction of property that places a child or others at serious threat
of violence or injury if no intervention occurs.
(8) The written policy must prohibit, at a minimum, any of the following aversive punishment
procedures:
(a) The use of noxious substances.
(b) The use of instruments causing temporary incapacitation.
(c) Chemical restraint as defined in the act.
(9) Restraint equipment and physical restraint techniques must not be used for punishment,
discipline, or retaliation.
(10) The use of a restraint chair is prohibited.