Updated Seclusion and Restraint Rules for Missouri

Two important changes to Missouri regulations that govern the use of restraint and seclusion for employees, contractors, and clients took effect on June 30, 2014 under the Children’s Division of the Missouri Department of Social Services:

Rules 13 CSR 35-71.045 – Personnel, Section 6, Staff Training mandates that all employees and contracted personnel must have 40 hours of training during the first year of employment and forty hours annually each subsequent year. Training is to include crisis intervention, de-escalation, and behavior management techniques and proper and safer methods and techniques of restraint to be used only as a last resort.

Each agency (including executive director, child care staff, professional staff, and recreation and activity staff) must establish and submit to the licensing unit an annual written plan for the 40 hours of training each year. All training must be documented with the dates, location, and subject and the names of the person(s) who conducted the training.

Direct care staff and immediate supervisors must maintain certification in crisis management and a current recognized and approved physical restraint program (where applicable).

13 CSR 35-71.070 – Protection and Care of the Child, Section 5 (E)(1) Physical Restraint mandates that all agencies using physical control techniques must have written policies defining the method of control, using a division-approved physical restraint training program.
Section H (6) also contains new staff documentation guidelines that state that physical restraint may be used as a management method only after all other verbal de-escalation measures have been exhausted, and never to replace other more positive measures.

Read more about these rules and what defines permissible use of seclusion and restraint.

CPI Training Can Help Your Facility Comply With the Rules

The Nonviolent Crisis Intervention^® training program equips staff in techniques for both the prevention of and the safe use of manual restraint. Our program provides training in identifying the underlying causes of the client behaviors that can lead to restraint, and in understanding how staff behavior affects client behavior, and vice versa. The training focuses on prevention and de-escalation techniques and other alternatives to the use of restraint, as well as information on evaluating risk of harm; monitoring for signs of distress; documenting incidents; and safer, less restrictive physical interventions to be used only as a last resort.

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