Minnesota Statutes section 245D.061 allows emergency use of manual restraint only when two conditions are both met: immediate intervention is needed to protect the person or others from imminent risk of physical harm, and the type of manual restraint is the least restrictive intervention that will eliminate the immediate risk and achieve safety. The restraint must end when the threat of harm ends. Staff must monitor the person's health and welfare during the restraint, and when possible the monitoring staff member should be someone other than the person implementing it. Providers must have a written policy, and staff must be trained before they may use emergency manual restraint. A provider may also choose not to allow it and must then describe the alternatives staff will use.
The statute sets a review sequence. Within three calendar days, the staff member who implemented the restraint reports in writing to the designated coordinator, including what less restrictive steps were tried, for how long, the person's condition before and after, any injuries and whether a debriefing happened. Within five working days of the restraint, the provider completes an internal review asking whether the person's supports need to change, whether policies were followed and adequate, and whether training or corrective action is needed. Within five working days after that, the provider consults the expanded support team to identify what led to the behavior, what function it may have served and whether the plan should change. Within five working days of that review, the provider sends the report, internal review and team summary to DHS and the Office of the Ombudsman for Mental Health and Developmental Disabilities.
The Positive Supports Rule also requires providers to use the DHS behavior intervention report form for several events, including any emergency use of manual restraint, a medical emergency or mental health crisis caused by a restrictive intervention, a behavioral incident that leads to a 911 call, an incident requiring a call to mobile crisis services, and use of an as-needed medication to intervene in a behavioral situation. Under part 9544.0070, three emergency uses of manual restraint within ninety days, or four within one hundred eighty days, trigger a positive support transition plan.
For case managers and oversight staff, these reports are information about a person's life. A cluster of reports often means something in the environment, staffing, health or plan is not working. Read them looking for patterns, and ask what will change.
