Prone Restraint in School: Minnesota's Experience - PACER Center

Prone Restraint in School:

Minnesota’s Experience

Tammy L. Pust

PACER Boardr

August 6, 2013

History in Minnesota

1975 – EAHCA/(now IDEA)

passed by US

1987 – “Rule 40” passed

regulating restrictive

procedures in MN-DHS

facilities

1993 – first “behavior

intervention rule” passed to

regulate seclusion/restraint in

MN schools

Some Definitions

“Restrictive Procedures” =

seclusion or physical holds

used in an emergency.

“Seclusion” = child alone;

egress barred

“Physical Holds” = body

contact used to limit

movement to prevent injury.

Recent History

2009 – MN’s behavior intervention rule repealed effective 8/2011 New law prohibited any

restraint that “impaired ability to breathe”

Didn’t use the word “prone restraint” Was prone restraint allowed

or banned?????

Would it be banned at effective date of repeal????

Not Prone Prone

Prone Restraint: Feds “Push” States

1998 Hartford

Currant report

1998 Harvard

Center for Risk

Analysis

2009 GAO report

July 2009 Letter to

the states from

Secretary Duncan,

US DOE

2012 Efforts in MN

Strengths = Partners

Strengths²

Lots of People Committed to Doing the

Best for Children

Data Collection and Required Reporting

Legal Framework that Already Existed in

State Law

Political Influence of Partners

DHS Litigation Settlement

Weaknesses

New Administration

Time Constraints

Under-developed

relationships with

potential partners

Threats

Lack of Trust

Differing Agendas

Partisan Politics

Economic Realities

Opportunities

Data

Data

Data

2012 Report and All the Data

http://education.state.mn.us/M

DE/SchSup/SpecEdComp/Co

mplMonitor/

Legislative Report

Summary of every incident

reported

Result: 2012 Legislative Changes

Gains:

Support for PBIS

“Prone” definition

Banned breathing or

communication

impairment and placing

any weight or pressure

on child

No prone if < age 5

Qtrly data reports

Effective date of repeal:

6/2013

“Losses”

Prior medical certification

Required reporting of ALL

restrictive procedures (not

just prone)

Got for 2012

Complete ban on prone

restraint

The Effort Continued

Legislative Mandate:

statewide plan to reduce

use of all restrictive

procedures, including

prone restraint

Stakeholders specified

PACER represented

Data collection

continued

What the Data Showed

All Restrictive Procedures 11-12

Incidents

16,604 holds

5,236 seclusions

21,840 incidents

Students

2,592/127,561 (total sped) = approx. 2%

Averages

physical holds/student = 7.2%

seclusion/student = 6.6%

restrictive procedures/student = 8.4%

Restrictive Procedures – by Age

All Restrictive Procedures - Gender

Restrictive Procedures - Disability

Restrictive Procedures by Race

Prone: Reports v. Incidents

Prone: Reports v. Incidents

7:1 – Male to Female

August 16, 2011 – January 13, 2012 596

January 14, 2012 – April 14, 2012 360

April 15, 2012 – July 14, 2012 462

Students\Incidents – by Disability

Prone Restraint by Race

2013 Group Recommendations

Use of Positive Behavior Interventions and Supports (PBIS)

Increasing Access to School-Linked Mental Health Services

Reduce Barriers to Accessing Day and Residential Treatment

Increase and Dedicate Safe School Levy Funds

Provide Training on Statutory Requirements

Develop Models for Post-Use Debriefing and Oversight Committee

Ensure Adequate Provider Training

Develop and Publish Resources

Define Data-Driven Process for MDE Targeted Technical Assistance

Continue Current Stakeholder Group Efforts

2013 Legislative Changes

Definition of “emergency”

Definition of “blocking egress” for seclusion

More detail for district oversight committee

Changes to requirements for post-use IEP Team meetings

Holding/seclusion can’t be used for discipline

Extended allowed use of prone restraint until 8/1/2015

Lessons Learned

Be at the table

Build coalitions

Knowledge is power: Get and

publish the data

Do the right thing

Spend necessary political capital

Set limits; Know who you are

sleeping with…

Never ever ever give up. Winston Churchill

Thanks PACER – for all you do

for kids and families!