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JKAA-PRC1

Restraint Prevention Procedure

JKAA-PRC1 

HOPKINTON PUBLIC SCHOOL COMMITTEE POLICY 
RESTRAINT PREVENTION PROCEDURE 
REVISED JULY 2019 

Maintaining an orderly, safe environment conducive to learning is an expectation of all staff members of the Hopkinton Public Schools. The Hopkinton Public Schools complies with the Department of Elementary and Secondary Education restraint regulations, 603 CMR 46.00 et. seq., to the extent required by law. According to the terms, the restraint regulations apply not only at school, but at school-sponsored events and activities, whether or not on school property. This policy shall be reviewed annually and provided to Hopkinton Public Schools staff and made available to the parents of enrolled students. Nothing in this policy precludes any teacher, employee, or agent of the Hopkinton Public Schools from using reasonable force to protect students, other individuals, or themselves from assault or imminent, serious, physical harm. 

Authority, Scope, Purpose and Construction 46.01 

(1) Authority. 603 CMR 46.00 is promulgated by the Board of Elementary and Secondary Education pursuant to M.G.L.c. 69, § 1B, and c. 71, § 37G. 

(2) Scope. 603 CMR 46.00 governs the use of physical restraint on students in publicly funded elementary and secondary education programs, including all Massachusetts public school districts, charter schools, virtual schools, collaborative education programs, and the school day of special education schools approved under 603 CMR 28.09, as provided in 603 CMR 18.05(5)(h). Educational programs in facilities operated by the Department of Youth Services, the Department of Mental Health, the Department of Public Health, or County Houses of Correction shall be governed by the restraint, seclusion, and time-out requirements of such agencies. 

(3) Purpose. The purpose of 603 CMR 46.00 is to ensure that every student participating in a Massachusetts public education program is free from the use of physical restraint that is inconsistent with 603 CMR 46.00. Physical restraint shall be used only in emergency situations of last resort, after other lawful and less intrusive alternatives have failed or been deemed inappropriate, and with extreme caution. School personnel shall use physical restraint with two goals in mind: 

(a) To administer a physical restraint only when needed to protect a student and/or a member of the school community from assault or imminent, serious, physical harm; and 

(b) To prevent or minimize any harm to the student as a result of the use of physical restraint. 

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(4) Construction. Nothing in 603 CMR 46.00 shall be construed to limit the protection afforded publicly funded students under other state or federal laws, including those laws that provide for the rights of students who have been found eligible to receive special education services. Nothing in 603 CMR 46.00 precludes any teacher, employee or agent of a public education program from using reasonable force to protect students, other persons or themselves from assault or imminent, serious, physical harm. 

Definitions 46.02 

1. Commissioner: shall mean the commissioner of the Department of Elementary and Secondary Education appointed in accordance with G.L. c.15, §1F, or his or her designee. 

2. Consent: shall mean agreement by a parent who has been fully informed of all information relevant to the activity for which agreement is sought, in his or her native language or other mode of communication, that the parent understands and agrees in writing to carrying out of the activity, and understands that the agreement is voluntary and may be revoked at any time. The agreement describes the activity and lists the records (if any) which will be released and to whom. In seeking parental consent, a public education program shall not condition admission or continued enrollment upon agreement to the proposed use of any restraint. 

3. Department: Shall mean the Department of Elementary and Secondary Education. 

4. Mechanical restraint: The use of a physical device or equipment to restrict the movement of a student. The term does not include devices implemented by trained personnel, or utilized by a student, that have been prescribed by an appropriate medical or related services professional, and are used for the specific and approved positioning or protective purposes for which such services were designed. 

5. Medication Restraint: The administration of medication for the purpose of temporarily controlling behavior. Medication prescribed by a licensed physician and authorized by the parent for administration in the school setting is not medication restraint. 

6. Parent: shall mean a student's father, mother, or legal guardian or person or agency legally authorized to act on behalf of the student in place of or in conjunction with the father, mother, or legal guardian. 

7. Physical escort: Temporary touching or holding a student without the use of force, of the hand, wrist, arm, shoulder or back for the purpose of inducing a student who is agitated to walk to a safe location. 

8. Physical restraint: Direct physical contact that prevents or significantly restricts a student’s freedom of movement. Physical restraint does not include brief physical 

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contact to promote student safety, providing physical guidance or prompting when teaching a skill, redirecting attention, providing comfort or a physical escort. 

9. Principal: Shall mean the instructional leader or headmaster of a public education school program or his or her designee. The board of directors of a charter school or virtual school, or special education school or program approved under 603 CMR 28.09, shall designate in the restraint prevention and behavior support policy who will serve as principal for purposes of 603 CMR 46.00. 

10.Prone Restraint: Physical restraint in which a student is placed face down on the floor or another surface, and physical pressure is applied to the student’s body to keep the student in the face-down position. 

11.Public education programs: Shall mean public schools, including charter schools, virtual schools, collaborative education programs, and the school day of special education schools approved under 603 CMR 28.09, as provided in 603 CMR 18.05(5)(h), and school events and activities sponsored by such programs. The term "programs" may be used in 603 CMR 46.00 to refer to "public education programs." For purposes of 603 CMR 46.00, public education programs shall not include the educational services provided within the Department of Youth Services, Department of Mental Health, Department of Public Health, and County Houses of Correction operated or contracted facilities. 

12.School Working Day: Any day or partial day that students are in attendance at the public education program for instructional purposes. 

13.Seclusion: Involuntary confinement of a student alone in a room or area in which the student is physically prevented from leaving. Seclusion does not include a time-out as defined in 603 CMR 46.02. 

14.Time Out: Time-out shall mean a behavioral support strategy developed pursuant to 603 CMR 46.04(1) in which a student temporarily separates from the learning activity or the classroom, either by choice or by direction from staff, for the purpose of calming. During time-out, a student must be continuously observed by a staff member. Staff shall be with the student or immediately available to the student at all times. The space used for time-out must be clean, safe, sanitary, and appropriate for the purpose of calming. Time-out shall cease as soon as the student has calmed. 

Use of Restraint 46.03 

The use of mechanical restraint, medical restraint and seclusion is prohibited. Prone restraint is prohibited except on an individual basis and only under the following circumstances: 

1. The student has a documented history of repeatedly causing serious self-injuries 3 of 12

and/or injuries to other students or staff; 

2. All other forms of physical restraint have failed to ensure the safety of the student and/or the safety or others; 

3. There are no medical contraindications as documented by a licensed physician; 4. There is no psychological or behavioral contraindications, as documented by a licensed mental health professional; 

5. The program has obtained consent to use prone restraint in an emergency. Consent means that the parent was fully informed of all relevant information, in his or her native language or other mode of communication and the parent understands and agrees in writing to use the use of prone restraint for emergency situations. The consent should describe to whom records will be released and that the agreement is voluntary and may be revoked at any time; 

6. The principal approves in writing of the use of prone restraint for emergencies; and 7. Steps one (1) through six (6) must be documented in advance of the use of the prone restraint. 

All physical restraints, including prone restraint where permitted, shall be administered in compliance with 603 CMR 46.05. 

Physical Restraint 

Physical restraint is an emergency procedure of last resort. It is prohibited, except when a student’s behavior poses a threat of assault, or imminent, serious, physical harm to self or others and the student is not responsive to verbal directives or other lawful and less intrusive behavior interventions, or such interventions are deemed to be inappropriate under the circumstances. 

Physical restraint will not be used; 

1. To discipline or punish students; 

2. When the student cannot be safely restrained because the restraint is 

medically contraindicated, such as students with asthma; 

3. As a response to property destruction, disruption of school order, a student’s refusal to comply with rules or staff directives; or verbal threats that do not constitute a threat of assault, or imminent, serious, physical harm; 

4. As a standardized response for an individual student, such as on an individualized education program (IEP). No individual behavior plan or IEP may include the use of physical restraint as a last resort. 

Only school personnel who have received in-depth training ( Safety Care ) shall administer physical restraint on students. Whenever possible the administration of physical restraint shall be administered in the presence of at least one adult who does not 

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participate in the restraint. 

Limitations on use of restraint. Physical restraint in the Hopkinton Public School District shall be limited to the use of such reasonable force as is necessary to protect a student or another member of the school community from assault or imminent, serious, physical harm. 

Nothing in these regulations prohibits: 

a) The right of any individual to report to appropriate authorities a crime committed by a student or other individual; 

(b) Law enforcement, judicial authorities or school security personnel from exercising their responsibilities, including the physical detainment of a student or other person alleged to have committed a crime or posing a security risk; or 

(c) The exercise of an individual's responsibilities as a mandated reporter pursuant to G.L. c. 119, § 51A. 603 CMR 46.00 shall not be used to deter any individual from reporting neglect or abuse to the appropriate state agency. 

Training 46.04 

Each building principal will identify staff members to serve as a school-wide resource to assist in ensuring proper administration of physical restraint. These staff members will participate in an in-depth training program in the use of physical restraint, with at least one refresher course occurring annually thereafter. 

In depth training will include: 

1. Appropriate procedures for preventing the need for physical restraint, including the de-escalation of problematic behavior, relationship building and the use of alternatives to restraint; 

2. A description and identification of specific dangerous behaviors on the part of students that may lead to the use of physical restraint and methods for evaluating the risk of harm in individual situations to determine whether the use of restraint is warranted; 

3. The simulated experience of administering and receiving physical restraint, instruction regarding the effect(s) on the person restrained, including instruction on monitoring physical signs of distress and obtaining medical assistance; 

4. Instruction regarding documentation and reporting requirements and investigation of inquiries and complaints; 

5. Demonstration by participants of proficiency in administering physical restraint; 6. Instruction regarding the impact of physical restraint on the student and family, 

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including but not limited to psychological, physiological, and social-emotional effects. 

HPS utilizes Safety-Care Behavioral Safety Training through QBS, Inc. The complete training includes instruction in the content areas of Incident Prevention, Incident Minimization, Physical Safety, Physical Management, Post Incident Procedures and Role Plays. The complete initial training will range from 12-14 hours. 

Recertification training (within specified time frame) will range from 6-8 hours to complete. 

● Annual initial complete trainings are offered for new staff or staff whose training has lapsed. These staff are identified based on building programs and crisis teams. 

● Annual recertification training in complete Safety Care are offered for previously trained staff. 

In addition, each staff member will be trained regarding the school’s physical restraint policy and procedures within the first month of the school year and, for employees hired after the school year begins, within one month of their employment. All staff must receive training with respect to the District’s restraint prevention and behavior support policy and requirements for when restraint is used. Training will include the following: 

1. The role of the student, family and staff in preventing restraint; 

2. The District’s restraint prevention and behavior support policy; 

3. Interventions that may preclude the need for restraint, including de-escalation of problematic behaviors, and other alternatives to restraint; 

4. The types of permitted physical restraint (to be used only when behavior presents an emergency that requires physical restraint), including information regarding the increased risk of injury to a student when restraint is used; 

5. Administering physical restraint in accordance with medical or psychological limitations, known or suspected trauma history, and/or behavior intervention plans as applicable to the individual student; 

6. Identification of specific staff who have received in-depth training in the use of physical restraint to serve as school-wide resource to assist in ensuring the proper administration of physical restraint. These individuals must participate in the in-depth training as explained above. 

Methods of Physical Restraint: 

The following are the types of physical restraint that the District uses; 

1. One Person Stability Hold: One staff person stands behind the student with the student’s arms crossed and held near the student’s waist. The staff person steps in close behind the student, facing sideways and placing his or her hip against the student’s backside for stability. 

2. Two Person Stability Hold: Two staff members approach the student from opposite sides. Both staff, with the outside hand, grasp the student’s closest arm just above the 

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wrist. With the inside hand, the staff inserts their arm through the student’s arm and grasps their own wrist securely. Staff then moves behind the student, facing outward with their hips behind the student’s hips. The student’s hands are kept near his or her pockets, with the arms slightly bent. 

3. Floor Seated Stability Hold: Staff members place the person into the 1-Person or 2-Person stability hold arm position, with one or both staff kneeling behind and to the side of the person with their closer knee down and the other leg supporting behind. 

4. Forward Transport: Beginning in a safe, secure and stable 2-Person Stability Hold, both staff take a small step as they bring their forward foot slightly outside the person’s foot. Staff shuffle forward, maintaining a broad and balanced stance and continuous contact, driving their hips gently but firmly forward to move the person forward. 

5. Reverse Transport: Beginning in a safe, secure and stable 2-Person Stability Hold, both staff transition to the reverse transport position by stepping forward with their outside leg, bringing the hand holding their own arm to the person’s forearm and grasping overhand, then pivoting around the person’s arm and bringing it up against their own torso. Staff reach under the person’s armpit with their inside arm, supporting under their shoulder with their arm while holding the outside arm above the wrist with an overhand grip. When stable they then walk the person backwards. 

6. Chair Stability Hold: Beginning in a safe, secure and stable 2-Person Stability Hold a third staff member gets a sturdy chair with arms and places it behind the person. The two staff holding the person’s arms walk the person back into the chair. The staff on the person’s arms kneel down on either side and somewhat behind the person with the outside leg out for stability. Staff maintain the same hold on the person’s arm as is used in the 2-Person Stability Hold. If necessary, the staff person on the chair can assist with stability by using a cupped hand to hold the outside of each of the person’s shoulders. 

Methods for Prevention of Student Violence, Self-Injurious Behavior and Suicide 

1. Individual crisis and safety planning, proactive building based strategies, faculty training, support teams and meetings, functional behavior assessments, behavior intervention plans, therapeutic supports and interventions by trained staff such as the school psychologists, counseling staff, education within general and special education curriculum/ health classes, referrals to community based agencies, communication to outside providers, parent consultation. Re-entry meetings and interventions for students returning from hospitalization. Outreach to 24-hour Emergency Services as needed. De-Escalation Techniques. 

● Positive behavioral interventions 

● Allowing personal space 

● Use of supportive words 

● Appropriate tone, volume and rhythm when speaking to the individual ● Verbal redirection 

● Verbal directive to cease behavior 

● Opportunity for a break 

● Opportunity for time-out 

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● Use of Safety Care techniques 

Methods for Engaging Parents and Youth in Discussions About Restraint Prevention 

Any parent with concerns about the use of physical restraint at any school within Hopkinton Public Schools may request a meeting with the building principal or the superintendent to discuss such concerns. Any individual who believes that a physical restraint of a student may have been unwarranted or conducted inappropriately may also make use of the grievance procedure described at the end of this document. 

Alternatives to Physical Restraint 

a. Alternatives 

Physical restraint shall not be used unless the following, less intrusive behavior interventions and supports have been unsuccessful or deemed inappropriate by school staff; 

● Positive behavioral interventions 

● Allowing personal space 

● Use of supportive words 

● Appropriate tone, volume and rhythm when speaking to the individual ● Verbal redirection 

● Verbal directive to cease behavior 

● Opportunity for a break 

● Opportunity for time-out 

● Use of Safety Care de-escalation techniques 

Procedure for Time-Out 

Time-out shall mean a behavioral support strategy developed pursuant to 603 CMR 46.04 (1) in which a student temporarily separates from the learning activity or the classroom, either by choice or by direction from staff, for the purpose of calming. During time-out, a student must be continuously observed by a staff member. Staff shall be with the student or immediately available to the student at all times. The space used for time-out must be clean, safe, sanitary, and appropriate for the purpose of calming. Time-out shall cease as soon as the student has calmed. 

Approval is required by the principal for use of time-out for over thirty (30) minutes. The principal should approve the continued time-out before the thirty (30) minutes expires. 

Proper Administration of Restraint 46.05 

A person administering the restraint shall use the safest method available and appropriate to the situation. Floor restraints, including prone restraints otherwise permitted under 603 CMR 46.03 

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shall be prohibited unless the staff members administering the restraint have received in-depth training according to the requirements and, in the judgment of the trained staff members, such method is required to provide safety for the student or others present. No restraint shall prevent a student from breathing or speaking and staff must continuously monitor a student’s physical status, such as skin temperature, color and respiration. If a student indicates that he or she is in significant physical distress or is observed to be in physical distress, including, but not limited 

to breathing or sustained or prolonged coughing or crying, the student should be released immediately and there should be steps taken to seek immediate medical assistance. 

Hopkinton Public Schools makes every effort to utilize a two minute fixed time release for all restraints. Following a duration of two minutes all restraints will be released to allow for assessment of the student’s presentation and need for ongoing intervention. 

If a student is restrained for a period of longer than twenty (20) minutes, program staff shall obtain the approval of the principal to continue the restraint. The principal should observe the student and make his or her determination based on the student’s continued agitation. 

After the release of a student from physical restraint, The Board Certified Behavior Analyst, Administrator or designee, may review the incident with the student to address the behavior that led to the restraint. The Board Certified Behavior Analyst, Administrator or designee, will review the incident with staff who administered the restraint to discuss whether proper procedures were followed and The Board Certified Behavior Analyst, Administrator or designee, will consider whether any follow-up is required for students who witnessed the incident. 

Reporting 46.06 

The program staff who administered a restraint shall report to the principal the use of any restraint verbally as soon as possible, and by written report no later than the next school working day. If the principal has administered the restraint, the principal will prepare the report and submit it to the superintendent or his or her designee. The principal or his or her designee shall maintain an ongoing record of all reported instances of physical restraint, which, upon request, shall be made available to the Department or the parent. 

The principal or designee must make reasonable efforts to verbally notify the parent of the restraint within twenty-four (24) hours and shall notify the parent by written report within three (3) school working days, either through an email address provided by the parent for communications about the student, or by regular mail. The report must be provided to the parent or guardian in the language in which report cards and other necessary school-related information are customarily provided. The principal will provide the student and parent an opportunity to comment orally and in writing. The principal of each building should create procedures for this notice. 

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The written report to the parent or guardian will 

contain: 

1. The name of the student, the job titles of staff who administered the restraint and observers, if any, the date of the restraint, the time the restraint began and ended, the name of the principal or designee who was verbally informed following the restraint, and if applicable, who approved the continuation of the restraint beyond twenty (20) minutes; 

2. A description of the activity in which the restrained student and other students and staff in the same room or vicinity were engaged immediately preceding the use of physical restraint; the behavior that prompted the restraint; the efforts made to prevent escalation of behavior, including the specific de-escalation strategies used; alternatives to restraint that were attempted; and the justification for initiating physical restraint; 

3. A description of the administration of the physical restraint including the holds used and reasons such holds were necessary; the student’s behavior and reactions during the restraint; how the restraint ended; and documentation of injury to the students and/or staff if any, during the restraint and any medical care provided; 

4. Information regarding any further action(s) that the school has taken or may take, including any consequences that may be imposed on the student; 

5. Information regarding opportunities for the student’s parent to discuss with school officials the administration of restraint, any consequences that may be imposed on the student, and any other related matter. 

Review of Records 46.06 

The principal at each building must conduct weekly reviews of restraint data to identify students who have been restrained multiple times during the week. If such students exist, the principal must convene a team to assess the student’s progress and needs; the events leading up to each restraint, such as time of day, day of week, antecedent events and individuals involved; factors that may have contributed to an escalation of behaviors, alternatives to restraint, including de-escalation techniques and possible interventions, and such other strategies and decisions as appropriate, with the goal of reducing or eliminating the use of restraint in the future. The review team must review and discuss the written reports submitted and any comments provided by the student and parent and create a written plan of action. If the principal participated in the restraint, the superintendent or designee should lead the discussion. 

The principal will ensure that a record of each individual student review is maintained and is available to the parent and the Department, upon request. 

The principal at each building will conduct monthly review of school- wide data to determine patterns in time of day, day of the week, or individuals involved; the number and duration of 

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physical restraints school-wide and for individual students; the duration of the restraints; and the number and type of injuries, if any resulting from the use of the restraint. The principal will determine whether it is necessary to modify the school’s restraint prevention and management policy, conduct additional staff training or take any other action that is necessary. 

When a physical restraint has resulted in an injury to a student or staff member, the district shall send a copy of the written report required by 603 CMR 46.06(4) to the Department postmarked no later than three school working days of the administration of the restraint. The district shall also send the Department a copy of the record of physical restraints maintained by the principal pursuant to 603 CMR 46.06(2) for the 30-day period prior to the date of the reported restraint. The Department shall determine if additional action by the district is warranted and, if so, shall notify the district of any required actions within 30 calendar days of receipt of the required written report(s). 

Report all physical restraints to the Department. Every district shall collect and annually report data to the Department regarding the use of physical restraints. Such data shall be reported in a manner and form directed by the Department. 

Procedure for Receiving and Investigating Complaints Regarding Restraint Policies 

This grievance procedure is established to ensure procedures are in place for receiving and investigating complaints regarding physical restraint practices. Any individual who believes that a physical restraint of a student may have been unwarranted or conducted inappropriately may file a complaint by utilizing this procedure: 

The complaint must be submitted in writing or on audiotape to the building Principal. Parents may opt to use the Hopkinton Public Schools Restraint Complaint Form. 

The Principal will meet with the complainant within ten (10) school days of receipt of the complaint. 

A thorough investigation will be conducted which may include interviewing witnesses, staff involved and/or the student; reviewing all written documentation leading up to and pertaining to the incident and all reports filed with the Director of Student Services and Superintendent. 

A written report will be developed by the Principal, reviewed by the Director of Student Services and Superintendent, and provided to the complainant. 

In the event the complainant is dissatisfied with the Principal’s investigation, the complainant may contact the Assistant Superintendent for further investigation and written determination. 

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The Superintendent’s determination will be the final determination of the District. 12 of 12