Michigan Restricts Physical Restraints in Foster Care
“The Michigan Department of Health and Human Services announced Thursday it is restricting the use of aggressive physical restraint of children in residential foster care facilities after the death of a teenager following an incident at one of its contracted facilities.
Cornelius Fredricks, 16, died after several staff members at Lakeside Academy in Kalamazoo restrained him, pressing his face down and laying on his upper body, to the point where the teenager’s body became limp and unresponsive. He died at Bronson Methodist Hospital of cardiac arrest two days later, officials said.
The new emergency rules, announced July 16, prevent facilities from using techniques of physical restraint that inhibit breathing on youth in Michigan’s foster care system. Lakeside’s contract was terminated and its license is suspended, according to MDHHS officials.
Robert Gordon, MDHHS director, said what happened to Fredricks was a tragedy and that his death “forces us to grapple with racism in the foster care system.”
“We have a responsibility to keep Black families safe and to provide our young Black people with the social support for them to succeed,” Gordon said. “That is what (Fredricks) deserved and didn’t get.”
The emergency rules were created with recommendations from national experts at the Annie E. Casey Foundation, according to Gordon.
“Restricting restraints is an important step, but the ultimate goal is to reform the system so young people get the care they deserve,” Gordon said. “The best way to improve is to learn from best practices around the country, and so I am grateful to our national partners for sharing their advice. We are listening with care.”
Jooyeu Chang, senior deputy director of the state’s Children Services Agency, said the recommendations are aimed at ending the large-scale institutional care of children.
“Children should be raised by families,” Chang said. “When foster care is absolutely necessary to keep kids safe, we have worked to place more children in family-like settings, rather than in residential facilities. If we must place children in child-caring institutions, it should be for therapeutic purposes to meet the child’s individual needs, and it should be for a limited amount of time,” Chang said.
Using physical restraint, Chang said, is not a therapeutic or caring way to address behavioral issues.
“It’s been overused, and it can be dangerous. That is why our goal is to eliminate this practice and put restrictions in place until we can do so.”
Chang said the state will now visit foster care facilities every three months. Before the emergency rules, the state visited facilities once a year.
MDHHS staff members will review restraint techniques that can and can’t be used, as well as perform on-site reviews. Chang said the department wants to create a complaint line for youth at foster facilities to report any misconduct they witness.
“We are making sure our staff are having more frequent communication with young people in our facilities,” Chang said.
Lakeside wasn’t following MDHHS policies before the incident occurred, Chang said.
“We did miss some of those early warning signs,” Chang said.
Since Fredricks’ death, MDHHS rapidly reviewed all its facilities to flag any serious incidents in the past two years and identified 76 facilities with issues that need to be addressed.
Additionally, all facilities contracted by MDHHS must communicate to a youth’s family that a restraint has been used within 12 hours of the incident. They must also alert the department of physical restraint being used within 24 hours of the incident.
“This is critical for learning and understanding how the use of restraints could be prevented,” Chang said.
The Annie E. Casey Foundation made the following recommendations for improving the safety and quality of foster care institutions in Michigan:
- Eliminating the use of coercive restraints in child-caring facilities, replacing the practice with interventions that follow national best practices and are therapeutic – meaning they will help children recover from trauma they have experienced – and removing seclusion as an intervention for addressing behavior problems.
- Engaging youth and families in conversations about how to improve child-caring institutions.
- Improving MDHHS oversight of the facilities through its licensing and contract processes.
- Improving the reporting and management of data.
National experts also advised limiting the frequency of and lengths of stay in residential placements.
“Today there are 876 children in residential settings – an 18 percent decrease from this time last year,” Chang said. “I am happy that we have made progress, but we must do better for our children and our families.”
Another recommended target area for improvement is the overrepresentation of children of color in child-caring institution.
“National data show that teenagers of color are much more likely than other children to be placed in institutions and group settings when they enter foster care,” said Sandra Gasca-Gonzalez, vice president for the Annie E. Casey Foundation’s Center for Systems Innovation. “It is time to walk away from outdated child welfare practices that force children and young people to grow up in facilities. Systems must move with urgency to embrace safe, equitable, family-focused approaches so young people thrive.”
The MDHHS emergency rules and the recommendations from national experts can be found on the department’s website.”
[MLive 07/16/2020 by Zahra Ahmad]
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