Section 441.115.9. Mechanical restraint.

When a facility uses mechanical restraints as a part of its treatment program, the facility shall have written policies regarding their use. These policies shall be approved by the licensor prior to their use. The policies shall be available to clients, parents or guardians, and referral sources at the time of admission. Policies shall also be available to staff.

       115.9(1) Restrictions on mechanical restraints.

        a.           Mechanical restraints shall not inflict physical injury.

        b.           Each use of mechanical restraint shall be authorized by the administrator or case supervisor.

        c.           Each authorization of mechanical restraint shall not exceed one hour in duration.

        d.           No child shall be kept in mechanical restraint for more than two hours in a 12-hour period.

        e.           Any time that a child is placed in mechanical restraint a staff person shall be assigned to monitor the placement with no duties other than to ensure that the child’s physical needs are properly met. The staff person shall remain in continuous auditory and visual contact with the child.

        f.            Each child shall be released from mechanical restraint as soon as the restraints are no longer needed.

       115.9(2) Continued use of mechanical restraints. When a child requires mechanical restraint on more than four occasions during any 30-day period, the facility shall hold an immediate emergency meeting to discuss the appropriateness of the child’s continued placement at the facility.

       115.9(3) In transporting children. Notwithstanding 115.9(1)“d,” mechanical restraint of a child in case of a secure facility while that child is being transported to a point outside the facility is permitted when there is a serious risk of the child exiting the vehicle while the vehicle is in motion. The facility shall place a written report on each use in the child’s case record. This report shall document the necessity for the use of restraint.

This rule is intended to implement Iowa Code section 237.4.